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The relationship between elderly suicide rates and the human development index: a cross-national study of secondary data from the World Health Organization and the United Nations

Published online by Cambridge University Press:  16 June 2008

Ajit Shah
Ajit Shah*
Affiliation:
Ageing, Ethnicity and Mental Health, University of Central Lancashire, Preston, U.K. and West London Mental Health NHS Trust, London, U.K.
*
Correspondence should be addressed to: Professor Ajit Shah, John Connolly Unit, West London Mental Health NHS Trust, Uxbridge Road, Southall, Middlesex UB1 3EU, U.K. Phone: +44 0208 354 8191; Fax: +44 0208 354 8898. Email: ajit.shah@wlmht.nhs.uk.
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Abstract

Background: Elderly suicides rates are associated with socio-economic status and life expectancy. Although suicide rates in younger people are associated with both higher and lower levels of educational attainment, little is known about this association in the elderly.

Method: The relationship between Human Development Index (HDI) – a composite index measuring average achievements on three basic dimensions of human development (life expectancy, educational attainment and socio-economic status) – and elderly suicide rates was examined in a cross-national study utilizing secondary data from the World Health Organization and the United Nations.

Results: There was a significant curvilinear (inverted U-shaped curve) relationship between elderly suicide rates in males and the HDI, fitting the quadratic equation y = a + bx − cx2. A similar curvilinear relationship was observed in females, but the significance level only approached 0.05.

Conclusions: A model with four sequential stages was proposed to explain the findings: (i) low elderly suicide rate – low human development society; (ii) high elderly suicide rate – low human development society; (iii) high elderly suicide rate – high human development society; and (iv) low elderly suicide rate – high human development society.

Keywords

elderly suicideslife expectancysocio-economic statuseducational status
Type
Research Article
Information
International Psychogeriatrics , Volume 21 , Issue 1 , February 2009 , pp. 69 - 77
Copyright
Copyright © International Psychogeriatric Association 2008

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References

Abel, E. L. and Kruger, M. L. (2005). Educational attainment and suicide rates in the United States. Psychological Reports, 97, 25–28.CrossRefGoogle ScholarPubMed
Abrahams, V. J., Abrahams, S. and Jacob, K. S. (2005). Suicide in the elderly in Kanyambadi block, Tamil Nadu, South India. International Journal of Geriatric Psychiatry, 20, 953–955.CrossRefGoogle Scholar
Barraclough, B. M. (1971). Suicide in the elderly. British Journal of Psychiatry, 6, 87–97.Google Scholar
Berk, M., Dodd, S. and Henry, M. (2006). The effect of macroeconomic variables on suicide. Psychological Medicine, 36, 181–189.CrossRefGoogle ScholarPubMed
Beautrais, A. L. (2003). Suicide and serious suicide attempts in youth: a multiple group comparison study. American Journal of Psychiatry, 160, 1093–1099.Google Scholar
Carlsten, A., Waern, M. and Allebeck, P. (1999). Suicides by drug poisoning among the elderly in Sweden 1969–1996. Social Psychiatry and Psychiatric Epidemiology, 34, 609–614.CrossRefGoogle ScholarPubMed
Cattell, H. (1988). Elderly suicides in London: an analysis of coroner's inquests. International Journal of Geriatric Psychiatry, 3, 251–261.CrossRefGoogle Scholar
Cattell, H. and Jolley, D. (1995). One hundred cases of suicide in the elderly. British Journal of Psychiatry, 166, 451–457.CrossRefGoogle Scholar
Conwell, Y., Rotenberg, M. and Caine, E. D. (1990). Completed suicides at age 50 and over. Journal of the American Geriatrics Society, 38, 640–644.Google Scholar
Conwell, Y., Olsen, K., Caine, E. D. and Flannery, C. (1991). Suicide in later life: psychological autopsy findings. International Psychogeriatrics, 3, 59–66.CrossRefGoogle ScholarPubMed
Cutright, P. and Fernquist, R. M. (2000). Effects of social integration, period, region, and culture of suicide on male age-specific suicide rates: 20 developed countries, 1955–1898. Social Science Research, 29, 148–172.CrossRefGoogle Scholar
Diekstra, R. F. W. (1989). Suicide and attempted suicide: an international perspective. Acta Psychiatrica Scandinavica, 80 (Suppl. 354), 1–24.Google Scholar
Fernquist, R. M. (2001). Education, race/ethnicity, age, sex, and suicide: individual level data in the United States, 1991–1994. Current Research in Social Psychology, 3, 277–290.Google Scholar
Fukuda, Y., Nakamura, K. and Takano, T. (2005). Cause-specific mortality differences across socioeconomic position of municipalities in Japan, 1973–1977 and 1993–1998: increased importance of injury and suicide in inequality for ages under 75. International Journal of Epidemiology, 34, 100–109.CrossRefGoogle ScholarPubMed
Gillis, A. R. (1994). Literacy and the civilisation of violence in 19th century France. Sociological Focus, 9, 371–401.Google Scholar
Gunnell, D., Middleston, N., Whitley, E., Dorling, D. and Frankel, S. (2003). Why are suicide rates rising in young men but falling in the elderly? A time-series analysis of trends in England and Wales 1950–1998. Social Science and Medicine, 57, 595–611.CrossRefGoogle ScholarPubMed
Hall, W., Mant, A., Mitchell, P., Rendle, V. A., Hickie, I. B. and McManus, P. (2003). Association between antidepressant prescribing and suicide in Australia, 1991–2000: trend analysis. BMJ, 326, 1008–1011.CrossRefGoogle ScholarPubMed
Hoxey, K. and Shah, A. K. (2000). Recent trends in suicide rates and methods in England and Wales. International Journal of Geriatric Psychiatry, 15, 274–279.3.0.CO;2-I>CrossRefGoogle ScholarPubMed
Jianlin, J. (2000). Suicide rates and mental health services in modern China. Crisis, 21, 118–121.CrossRefGoogle ScholarPubMed
Kiemo, K. (2004). Towards a socio-economic and demographic theory of elderly suicides: a comparison of 49 countries at various stages of development. www.soc.ou.se/publications/fulltext/diss2003-3.pdf. Last accessed 2 February 2007.Google Scholar
Kowalski, G. S., Faupel, C. E. and Starr, P. D. (1987). Urbanization and suicides: a study of American counties. Social Forces, 66, 85–101.CrossRefGoogle Scholar
Kua, E. H., Ko, S. M. and Ng, T. P. (2003). Recent trends in elderly suicide rates in a multi-ethnic Asian city. International Journal of Geriatric Psychiatry, 18, 533–536.Google Scholar
Kung, H. C., Liu, X. and Juon, H. S. (2004). Risk factors for suicide in Caucasians and in African Americans: a matched case-control study. Social Psychiatry and Psychiatric Epidemiology, 33, 155–161.Google Scholar
Lester, D. (1990)–1991. Mortality from suicide and homocide for African Americans in the USA: A regional analysis. Omega: Journal of Death and Dying, 22, 216–226.Google Scholar
Lindesay, J. (1991). Suicide in the elderly. International Journal of Geriatric Psychiatry, 6, 355–361.Google Scholar
Lodhi, L. and Shah, A. K. (2004). Psychotropic prescriptions and elderly suicide rates. Medicine, Science and the Law, 44, 236–244.CrossRefGoogle ScholarPubMed
Lodhi, L. and Shah, A. K. (2005). Factors associated with the recent decline in suicide rates in England and Wales: 1985–1998. Medicine, Science and the Law, 45, 115–120.CrossRefGoogle ScholarPubMed
Lorant, V., Kunst, A. E., Huisman, M., Costa, G. and Mackenbach, J. (2005). Socio-economic inequalities in suicide: a European comparative study. British Journal of Psychiatry, 187, 49–54.Google Scholar
Mayer, P. (2000). Development, gender equality, and suicide rates. Psychological Reports, 87, 367–372.Google Scholar
McIntosh, J. L. (1984). Components of the decline in elderly suicides: suicide in young old and old old by race and sex. Death Education, 8, 113–124.CrossRefGoogle Scholar
Moscicki, E. K. (1995). North American perspectives: epidemiology of suicide. International Psychogeriatrics, 7, 137–148.CrossRefGoogle Scholar
Otsu, A., Araki, S., Sakai, R., Yokoyama, K. and Voorhees, A. S. (2004). Effects of urbanization, economic development, and migration of workers on suicide mortality in Japan. Social Sciences and Medicine, 58, 1137–1146.CrossRefGoogle ScholarPubMed
Rubenowitz, E., Waern, M., Wilhelmson, K. and Allebeck, P. (2001). Life events and psychosocial factors in elderly suicides – a case control study. Psychological Medicine, 31, 1193–1202.Google Scholar
Seiden, R. H. (1981). Mellowing with age: factors affecting the non-white suicide rate. International Journal of Ageing and Human Development, 13, 265–284.Google Scholar
Shah, A. K. (2007a). The relationship between suicide rates and age: an analysis of multinational data from the World Health Organization. International Psychogeriatrics, 19, 1141–1152.CrossRefGoogle ScholarPubMed
Shah, A. K. (2007b). The importance of socio-economic status of countries for mental disorders in old age: development of an epidemiological transition model. International Psychogeriatrics, 19, 785–787.Google Scholar
Shah, A. K. (2007c). Elderly suicide rates in the United Kingdom: trends from 1979 to 2002. Medicine, Science and the Law, 47, 56–60.Google Scholar
Shah, A. K. and De, T. (1998). Suicide and the elderly. International Journal of Psychiatry in Clinical Practice, 2, 3–17.Google Scholar
Shah, A. K. and Ganesvaran, T. (1994). Suicide in the elderly. In Chiu, E. and Ames, D. (eds.), Functional Psychiatric Disorders of the Elderly (pp. 221–244). Cambridge: Cambridge University Press.CrossRefGoogle Scholar
Shah, A. K., Ellanchanny, N. and Collinge, T. (2001). Trends in age band-specific suicide rates in the elderly. Medicine, Science and the Law, 41, 102–106.Google Scholar
Shah, R., Uren, Z., Baker, A. and Majeed, A. (2002). Trends in suicide from drug overdose in the elderly in England and Wales, 1993–1999. International Journal of Geriatric Psychiatry, 17, 416–421.Google Scholar
Shah, A. K., Bhat, R., MacKenzie, S. and Koen, C. (2007a). Elderly suicide rates: cross-national comparisons and association with sex and elderly age-bands. Medicine, Science and the Law, 47, 244–252.Google Scholar
Shah, A. K., Padayatchi, M. and Das, K. (2007b). The relationship between elderly suicide rates and elderly dependency ratios: a cross-national study using data from the WHO data bank. International Psychogeriatrics. [published 2008, 20, 596–604].Google ScholarPubMed
Shah, A. K., Bhat, R., MacKenzie, S. and Koen, C. (2007c). Elderly suicide rates: cross-national comparisons over a 10-year period. International Psychogeriatrics. E-published ahead of print, DOI: 10.1017/S1041610207006266.Google Scholar
Shah, A. K., Bhatt, R., MacKenzie, S. and Koen, C. (2008a). A cross-national study of the relationship between elderly suicide rates and life expectancy and markers of socio-economic status and healthcare. International Psychogeriatrics, 20, 347–360.Google Scholar
Simpson, M. E. and Conklin, G. H. (1989). Socioeconomic development, suicide and religion: a test of Durkheim's theory of religion and suicide. Social Forces, 67, 945–964.Google Scholar
Stack, S. (1998). Education and risk of suicide: an analysis of African Americans. Sociological Focus, 31, 295–302.Google Scholar
Suh, G. K. and Shah, A. K. (2001). A review of epidemiological transition in dementia: cross-national comparisons of the indices related to Alzheimer's disease and vascular dementia. Acta Psychiatrica Scandinavica, 104, 4–11.CrossRefGoogle Scholar
Vassilas, C. A. and Morgan, H. G. (1993).General practitioner's contact with victims of suicide. BMJ, 307, 300–301.Google Scholar
Vassilas, C. A. and Morgan, H. G. (1994). Elderly suicides' contact with their general practitioner before death. International Journal of Geriatric Psychiatry, 9, 1008–1009.Google Scholar
Vijayakumar, L., Nagaraj, K., Pirkis, J. and Whiteford, H. (2005). Suicide in developing countries (1): frequency, distribution, and association with socio-economic indicators. Crisis, 26, 104–111.CrossRefGoogle Scholar
Wasserman, D., Cheng, Q. and Jiang, G. X. (2005). Global suicide rates among young people aged 15–19. World Psychiatry, 114–120.Google Scholar
Whitley, E., Gunnell, D., Dorling, D. and Smith, G. D. (1999). Ecological study of social fragmentation, poverty, and suicide. BMJ, 319, 1034–1037.CrossRefGoogle ScholarPubMed
Willis, L. A., Coombs, D. W., Drentea, P. and Cockerham, W. C. (2003). Uncovering the mystery: factors of African American suicide. Suicide and Life Threatening Behaviour, 33, 412–429.CrossRefGoogle ScholarPubMed
Yip, P. S. F. (2001). An epidemiological profile of suicides in Beijing, China. Suicide and Life-Threatening Behaviour, 31, 62–70.CrossRefGoogle ScholarPubMed
Yip, P. S. F. and Tan, R. C. E. (1998). Suicides in Hong Kong and Singapore: a tale of two cities. International Journal of Social Psychiatry, 44, 267–279.Google Scholar
Yip, P. S. F., Callanan, C. and Yuen, H. P. (2000). Urban/rural and gender differences in suicide rates: East and West. Journal of Affective Disorders, 57, 99–106.Google Scholar
Yip, P. S. F., Liu, K. Y., Hu, J. and Song, X. M. (2005). Suicide rates in China during a decade of rapid social change. Social Psychiatry and Psychiatric Epidemiology, 40, 792–798.Google Scholar
Zhang, J. (1998). Suicide in the world: toward a population increase theory of suicide. Death Studies, 22, 525–539.CrossRefGoogle Scholar